tbuckley/cabot-search huggingface dataset:
POS0946 THE COURSE OF BONE MINERAL DENSITY DURING 8 YEARS OF TREATMENT WITH TNF-α INHIBITORS IN PATIENTS WITH ANKYLOSING SPONDYLITIS
Authors: M. Siderius, A. Spoorenberg, F. Wink, S. Arends
Journal: Annals of the Rheumatic Diseases (2022)

Background Bone loss reflected by lower bone mineral density (BMD) compared to age and gender matched healthy controls is a common feature of ankylosing spondylitis (AS) and can already be observed at early stages of the disease 1 . AS patients starting TNF-α inhibitors (TNFi) show overall a rapid increase in BMD 2 . However, the course of BMD during long-term TNFi in these patients is not known. Objectives To assess the course of BMD of the lumbar spine (LS) and hip in AS patients treated with TNFi during 8 years. Methods Patients from the GLAS cohort who received TNFi for at least 8 years were included. Patients were excluded when they used bisphosphonates. BMD of the LS (AP projection L1-L4) and hip (total proximal femur) was measured at baseline, 1 year, 2 years and then bi-annually using DEXA. Low BMD was defined as LS and/or hip BMD Z-score ≤1. Generalized estimating equations were used to analyze BMD Z-scores over time within subjects. Results 131 AS patients were included; 73% were male, mean ± SD age was 41.3 ± 10.8 years, median (IQR) symptom duration was 14 (7-24) years, 83% were HLA-B27+, mean ASDAScrp was 3.8 ± 0.8, median CRP level was 13 (6-22) mg/L, and median vitamin 25(OH)D3 was 61 (46-80) nmol/L at baseline. Disease activity showed rapid and sustained during TNFi treatment, with mean ASDAScrp of 2.1 ± 0.9 and median CRP of 2 (2-5) at 8 years. Serum levels of vitamin D remained stable, with median vitamin 25(OH)D3 of 60 (47-81) at 8 years. At baseline, mean LS and hip BMD Z-scores were -0.37 ± 1.08 and -0.05 ± 1.04, respectively. Low BMD at the LS and hip (Z-score ≤1) was present in 34% and 19% of patients, respectively. Overall, both LS and hip BMD Z-scores improved significantly during TNFi at all follow-up visits compared to baseline. Significant improvement of BMD Z-scores compared to the previous time point was found up to and including 4 years for LS and up to and including 2 years for hip. Thereafter, deflection of improvement was observed. Median percentage of improvement in absolute BMD after 8 years of TNFi compared to baseline was 7.1% (IQR 0.8-13.5) for LS and 1.6% (IQR -3.5-5.5) for hip (Figure 1). At 8 years, low BMD at the LS and hip (Z-score ≤1) was present in 23% and 19% of patients, respectively. Conclusion In AS patients treated long-term with TNFi, both hip and LS BMD significantly increased especially during the first 2-4 year of treatment and stabilized thereafter. This effect was most pronounced in the LS and small in the hip. References [1]Van der Weijden et al. Clin Rheumatol. 2012 Nov;31(11):1529-35 [2]Arends et al. Arthritis Res Ther. 2012;14(2):R98 Disclosure of Interests Mark Siderius: None declared, Anneke Spoorenberg Consultant of: AbbVie, Novartis Pharma, Pfizer, UCB Pharma, Lilly, Grant/research support from: Novartis Pharma, Pfizer, Employee of: AbbVie, Novartis Pharma, Pfizer, UCB Pharma, Lilly, Freke Wink: None declared, Suzanne Arends: None declared
AB0663 Bicentric observational study on the therapeutic management of patients with rheumatoid arthritis and systemic sclerosis overlap syndrome
Authors: N. Lebel, C. Marcelli, I. Marie, H. Levesque, T. Lequerre, O. Vittecoq
Journal: Annals of the Rheumatic Diseases (2022)

Background The rheumatoid arthritis (RA)/systemic sclerosis (SSc) overlap syndrome is a rare and understudied association. It affects 5% of patients with SSc. Only open studies evaluating biological drugs (bDMARDs) have reported encouraging results, particularly on joint involvement. The management of these patients is therefore not codified. Objectives The objective was to analyze in real conditions the therapeutic strategy and the response to bDMARDs, with a focus on joint involvement. Methods We retrospectively analyzed over a 10-year period the clinical, biological, radiographic characteristics and therapeutic management of patients meeting the ACR/EULAR diagnostic criteria for RA and SSc in two academic centers. Response to bDMARDs was assessed according to EULAR and if unavailable according to therapeutic maintenance. The evolution of lung function test was also evaluated. Results Twenty-two patients were identified. Interstitial lung involvement was common (n=11). Only 7 patients were treated with csDMARD alone. The most commonly used drug was methotrexate. The use of bDMARDs was frequent (15/22), significantly greater in patients with rheumatoid factors (OR 26.7; p=0.004) and with a trend in patients with higher levels of anti-CCP (160 vs 15 IU; p=0.11) or diffuse interstitial lung disease (OR 10.6; p=0.063). Tocilizumab was the most selected therapy (n = 8) followed by rituximab (n = 5), abatacept, and anti-TNFs (n = 4 respectively). We evaluated 21 treatment sequences, 19 of which were evaluated according to EULAR response criteria. bDMARDS that inhibits the activation of lymphocytes (abatacept, rituximab) generally resulted in a good or moderate response (n = 9/10) with a significant decrease in DAS28 at 6 months (-1.75; p = 0.016). Cytokine inhibitors (tocilizumab, etanercept, infliximab) were less likely to achieve good or moderate control of joint involvement (n = 3/9) with a smaller decrease in DAS28 at 6 months (-0.79; p = 0.36). Two tocilizumab sequences were stopped early due to intolerance and could not be evaluated. One patient received tofacitinib with a good clinical response but was discontinued at 9 months for intolerance. Lung function test data did not change significantly on bDMARD. Conclusion In patients with rheumatoid arthritis (RA)/systemic sclerosis (SSc) overlap syndrome, bDMARDS that inhibits the activation of lymphocytes (abatacept, rituximab) resulted in more frequent and greater improvement in joint involvement than cytokine inhibitors (tocilizumab, etanercept, infliximab). Disclosure of Interests None declared
AB0370 COMPARISON OF A NEW RANDOM-ACCESS SOLUTION FOR THERAPEUTIC DRUG MONITORING OF ADALIMUMAB TO THE REFERENCE ELISA TEST
Authors: A. Ruiz del Agua, R. El Hamss, M. Moneo, M. B. Ruiz-Argüello, D. Nagore
Journal: Annals of the Rheumatic Diseases (2022)

Background Despite numerous studies, Therapeutic Drug Monitoring (TDM) of biological therapies is still debated partly motivated by the accessibility to a ready-to-use monotest device capable of delivering accurate results in a timely manner without the burden of sample batching, therefore allowing immediate decision making. Objectives We aimed at comparing the new Chorus Promonitor Adalimumab monotest running in the fully automated random-access Chorus TRIO system to the reference ELISA test Promonitor ADL run in a Triturus system. Methods Chorus Promonitor Adalimumab (Diesse Diagnostica Danese, Italy) is an immunoassay kit for the automated quantitative detection of adalimumab (ADL) in human serum using a ready-to-use disposable monotest device applied on the Chorus TRIO (Diesse Diagnostica Danese, Italy) instrument, a random-access single test multiparametric system for immuno-colorimetric assays. The new device implements the same specific reagents as in the reference ELISA test Promonitor ADL (Progenika, Spain) run in a Triturus (Grifols, Spain) system, therefore ensuring the same analytical specificity and applicability for patient monitoring previously demonstrated with the predicate ELISA. The new monotest device contains all the reagents necessary to perform the assay, and a lot-specific master curve method is used for calibrating. The comparison was performed in a set of 53 serum samples from patients under ADL therapy that covered the entire drug trough concentrations found in clinical practice (up to 30 ug/mL). Pearson’s correlation, Bland-Altman and Passing-Bablok regression analysis were used to study the association and quantitative comparison between the methods. Results Time to first result for the Chorus Promonitor Adalimumab test was 2 hours and 45 min minutes and after this a new result was delivered every 30 seconds. Positive and negative percent agreements between both tests were 100%. A high correlation between both tests was found (coefficient of correlation of 0.959, p&lt;0.01). The Passing-Bablok regression analysis determined an excellent comparability of both data sets with a slope of 1.032 (0.952-1.129) with an intercept of -0.428 (-1.292-0.053). Figure 1. Conclusion The Chorus Promonitor Adalimumab represents the first evolution of the gold-standard Promonitor ELISA technology into a monotest random-access technology that enables quick turnaround time to facilitate TDM for ADL and aid immediate decision making. Disclosure of Interests None declared
AB1364 IMAGING DIAGNOSIS OF BRUCELLAR SPONDYLODISCITIS
Authors: S. Rekik, S. Boussaid, H. Tbini, S. Jemmali, S. Rahmouni, K. Zouaoui, H. Sahli, M. Elleuch
Journal: Annals of the Rheumatic Diseases (2022)

Background Spondylodiscitis is the most common location in the musculoskeletal involvement of brucellosis. Objectives The aim of this study is to describe magnetic resonance imaging (MRI) and computed tomography scan (CT) results in patients with brucellar spondylodiscitis. Methods A retrospective study over a period of 15 years, including 18 patients diagnosed with brucellar spondylodiscitis and having benefited from a CT scan and/or an MRI of the spine. Results Eighteen patients were included. In all cases spinal pain was reported, associated with radiculalgia in 8 patients. Low back pain was the most common symptom, present in 17 cases, associated with back pain in 3 cases including one case with neck pain. Isolated neck pain was noted in one patient. Neurologic examination was normal in all cases. Standard Radiographs showed disc narrowing in 14 cases, erosions in 9 cases and hazy changes of the vertebral end plate in 2 cases. A CT scan was performed in 11 cases. It showed disc narrowing in 6 cases, erosions in 3 cases and endplate destructions in 5 cases. Abscesses were found in 4 patients. Complementary MRI was performed in three of the patients who had already undergone CT. The MRI results were consistent with those of the CT scan, except for one patient in whom it revealed spondylodiscitis while the CT scan revealed degenerative lesions. Eleven patients underwent MRI in total. It showed unifocal and multifocal spondylodiscitis in 5 and 6 cases respectively, epiduritis in 6 cases, spinal cord compression in 2 cases and abscesses in 4 cases. Conclusion Our study showed that CT and spinal MRI allow early diagnosis of spondylodiscitis. They help to identify asymptomatic lesions and neurological complications. Disclosure of Interests None declared
Internet Searches for Abortion Medications Following the Leaked Supreme Court of the United States Draft Ruling
Authors: Adam Poliak, Nora Satybaldiyeva, Steffanie A. Strathdee, Eric C. Leas, Ramesh Rao, Davey Smith, John W. Ayers
Journal: JAMA Internal Medicine (2022)

This cross-sectional study evaluates whether internet searches for abortion medications increased following the leak of a draft Supreme Court of the United States ruling that would overturn the 1973 Roe v Wade decision.
AB1579-PARE THE EFFECTS OF A HEALTH EDUCATION PROGRAMME ON PATIENTS’ SYMPTOMS AND LIFESTYLE CHANGES IN PATIENTS WITH KNEE OSTEOARTHRITIS ATTENDING A TERTIARY CARE CLINIC IN SRI LANKA
Authors: S. Janagan, R. M. Wickramarachchi, M. De Silva
Journal: Annals of the Rheumatic Diseases (2022)

Background Osteoarthritis is the major cause of joint pain and disability among middle aged and elderly with no disease specific treatment. Management includes analgesics, lifestyle changes and physical therapy. Objectives We aimed to study the demographics of the patients and knowledge regarding osteoarthritis among those who attended our clinic with mechanical knee pain and the effects of a health education programme. Methods Patients complaining of mechanical knee pain who were found to have examination findings suggestive of knee joint osteoarthritis were enrolled in this study (N-150). Where available diagnosis was confirmed by radiography. Data was collected when they attended a health education programme which focused on lifestyle changes in osteoarthritis including diet and exercise (n-76). An interviewer administered questionnaire regarding disease, dietary changes for reduction of weight and exercise was used to obtain data before and 3 months after the health education programme. Anthropometric measurements were taken using validated instruments. Data was analyzed using SPSS software. Results Response rate was 50.67 %.The average age of the study population was 54.8 years and constituted of 92.1 % females. About one fifth of them had received only primary school and 50 percent were unemployed. The average BMI was 29.68 (SD-5) and average WOMAC score was 44.1 (SD -19.4). Their knowledge of healthy dietary habits, primarily to lose weight and exercises for knees were assessed before the health education programme and 3 months later. Table 1. Before health education 3 months after health education n 76 20 BMI (average) 29.68 30.2 Not aware of disease 90% 50% Aware of diet to reduce weight 32% 65% Aware of exercises 5 % 35% WOMAC score 44.1 36.7 There was no statistically significant correlation between WOMAC score and age, educational level or BMI.Though the knowledge regarding disease and lifestyle measures improved significantly(p&lt; 0.05) following the health education program, there was no significant difference in the WOMAC score. Conclusion Health education was seen to improve the knowledge regarding disease and lifestyle measures despite no significant improvement in the pain or disability scores.Further studies are needed to see the long term effects of health education. References [1]Jönsson, T., Eek, F., Dell’Isola, A., Dahlberg, L. E., &amp; Ekvall Hansson, E. (2019). The Better Management of Patients with Osteoarthritis Program: Outcomes after evidence-based education and exercise delivered nationwide in Sweden. PloS one , 14 (9), e0222657. doi:10.1371/journal.pone.0222657 [2]Espanha M, Marconcin P, Campos P, et alPARE0005 Educational program for older adults with knee osteoarthritisAnnals of the Rheumatic Diseases 2017;76:1553. Disclosure of Interests None declared
AB0520 ASSOCIATION BETWEEN LEFT VENTRICULAR MASS INDEX AND BODY WEIGHT IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS
Authors: A. N. Garza-Cisneros, D. Á. Galarza-Delgado, J. R. Azpiri-López, I. J. Colunga-Pedraza, M. A. Balderas-Palacios, A. Garcia-Heredia, N. Guajardo-Jauregui, A. B. Rodriguez-Romero, A. Cárdenas
Journal: Annals of the Rheumatic Diseases (2022)

Background Rheumatoid cachexia is a clinical spectrum of rheumatoid arthritis in which individuals present increased inflammatory activity, more aggressive joint destruction, and worse cardiovascular prognosis (1). Systemic lupus erythematosus (SLE) is a chronic, inflammatory, autoimmune disease in which there is a high cardiovascular mortality rate (2). Currently, the cachexia phenomenon in SLE patients has not been studied. Objectives To correlate body weight with left ventricular (LV) indexed mass in SLE patients. Methods This was a cross-sectional study that included a total of 34 patients aged ≥18 years with a diagnosis of SLE according to EULAR/ACR 2019 criteria. Patients with a personal pathological history of cardiovascular disease (myocardial infarction, stroke, or peripheral arterial disease) and pregnancy were excluded. Three certified cardiologists performed a transthoracic echocardiogram in each patient, assessing relative wall thickness, and indexed LV mass. The distribution was assessed with Kolmogorov-Smirnov. Correlations between weight and echocardiographic parameters with Spearman-rho coefficient. A value of p&lt;0.05 was considered statistically significant. Results Most patients were female (94.1%), with a mean age of 33.29±9.91. Of the total patients 2 (5.88%) had Type 2 Diabetes Mellitus, 2 (5.88%) hypertension, 1 (2.94%) dyslipidemia, 3 (8.82%) obesity, and 6 (17.64%) smoking. Spearman-rho coefficient showed a significant negative correlation between LV indexed mass and body weight of SLE patients (rho=-0.411, p =0.016) (Figure 1). Figure 1. Spearman rho correlation between weight and LV indexed mass. Conclusion There is a negative correlation between body weight and LV indexed mass in SLE patients, this suggests that a lower body weight may be related to higher LV mass, which may result in LV hypertrophy and increased cardiovascular morbidity and mortality. References [1]Summers GD, Metsios GS, Stavropoulos-Kalinoglou A, Kitas GD. Rheumatoid cachexia and cardiovascular disease. Nat Rev Rheumatol [Internet]. 2010;6(8):445–51. Available from: http://dx.doi.org/10.1038/nrrheum.2010.105 [2]Lee YH, Choi SJ, Ji JD, Song GG. Overall and cause-specific mortality in systemic lupus erythematosus: An updated meta-analysis. Lupus. 2016;25(7):727–34. Disclosure of Interests None declared
POS1174 COLCHICINE TREATMENT IN GOUT PATIENTS – IMPACT ON CARDIOVASCULAR EVENTS AND ON MORTALITY
Authors: Y. Braun-Moscovici, L. Gabay, Y. Butbul
Journal: Annals of the Rheumatic Diseases (2022)

Background Gout and hyperuricemia are independent risk factors for cardiovascular events and increased mortality. A significant proportion of gout patients receive colchicine, additionally to urate-lowering therapy. Recently, colchicine treatment was found to reduce the risk of cardiovascular events in patients with chronic cardiac disease. Objectives To assess the incidence of cardiovascular events and the mortality rate among gout patients who received colchicine treatment. Methods This retrospective cohort study was conducted using data from the Maccabi Healthcare Services (MHS) central computerized database. MHS is the second largest state-mandated health care provider in Israel, covering &gt;2.5 million members (25% of the population) and is a representative sample of the Israeli population. The study included gout patients from the MHS registry aged ≥40 years who received colchicine for at least 3 months and a control group matched by age, gender and socioeconomic status. The data extracted included smoking status, body mass index (BMI), co-morbidities (diabetes, hypertension, chronic renal disease, hyperlipidemia, malignancy), antiplatelet and anticoagulant treatment, cardiovascular events and mortality rate. The statistical analysis included univariate and cox regression analysis. Results 3671 individuals were included in each group (mean(SD) age 56(12.5), 87% males, mean(SD) follow-up 2744.7(1616.2) days). The gout group had a statistically significant higher incidence (p&lt;0.001) of cardiovascular events (14.7% vs 10.8%), high BMI (35.1% vs 15%), diabetes (17% vs 12.7%), hypertension (52% vs 32.4%), chronic renal disease (35% vs 15%), hyperlipidemia (65% vs 46%). The mortality rate was similar (8.9% vs 7.9%, p=0.11) for both groups. The mortality hazard ratio (95% CI) for gout patients was 1.18 (1-1.39, p=0.05), for diabetes 1.6 (1.3-1.9, p&lt;0.0001), for hypertension 1.38 (1.1-1.67, p=0.002). Conclusion Although the gout patients had a higher incidence of co-morbidities and cardiovascular events, the mortality rate was not significantly different compared to the matched group. Chronic colchicine treatment might have a protective effect. Further long-term studies are required. Disclosure of Interests None declared
Author Correction: Susceptibility to hormone-mediated cancer is reflected by different tick rates of the epithelial and general epigenetic clock
Authors: J. James E. Barrett, Chiara Herzog, Yoo-Na Kim, Thomas E. Bartlett, Allison Jones, Iona Evans, David Cibula, Michal Zikan, Line Bjørge, Nadia Harbeck, Nicoletta Colombo, Sacha J. Howell, Angelique Flöter Rådestad, Kristina Gemzell-Danielsson, Martin Widschwendter
Journal: Genome biology (2022)
Characterization of mucosal‐associated invariant T cells in blood of patients with axial spondyloarthritis and in axial entheses of healthy controls: comment on the article by Rosine et al
Authors: Eric Toussirot, Caroline Laheurte, Philippe Saas
Journal: Arthritis & Rheumatology (2022)

Disclosure Form Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
AB0068 INTERLEUKIN 40 SERUM LEVELS ARE ELEVATED IN PATIENTS WITH EARLY RHEUMATOID ARTHRITIS AND ASSOCIATE WITH NEUTROPHIL ACTIVATION
Authors: A. Navrátilová, V. Becvar, H. Hulejova, K. Pavelka, J. Vencovský, L. Šenolt, L. Andres Cerezo
Journal: Annals of the Rheumatic Diseases (2022)

Background IL-40 is a newly described cytokine associated with immune system function and malignant transformation. We have recently shown that IL-40 is up-regulated in rheumatoid arthritis (RA) and associates with disease activity, autoantibodies and NETosis 1 . Objectives As autoantibodies and neutrophil activation are factors thought to drive the pathological processes at early phase of RA development, we aimed to investigate IL-40 in relation to neutrophils and early stages of RA (ERA). Methods The levels of serum IL-40 were determined in a cohort of treatment naïve patients with ERA at baseline (n=60) and three months after initiation of conventional treatment (n=60). Serum IL-40 was also determined in sex- and age- matched healthy controls (n=60). Levels of IL-40, cytokines and NETosis markers (proteinase 3, PR3 and neutrophil elastase, NE) were measured by commercially available ELISA kits. The levels of autoantibodies were analysed by routine laboratory techniques. In vitro experiments were performed on peripheral blood neutrophils from patients with ERA (n=15). Results Levels of IL-40 were elevated in ERA patients at baseline compared to healthy controls (p&lt;0.0001) and normalised after three months of the treatment (p&lt;0.0001). Baseline serum IL-40 was associated with the levels of autoantibodies RF (IgM) (p&lt;0.01) and anti-CCP (p&lt;0.01) and markers of NETosis PR3 and NE) (both p&lt;0.0001). Moreover, significant decreases in the serum IL-40 following the therapy correlated with the decrease of NETosis markers PR3 (p&lt;0.01) and NE (p&lt;0.05). In vitro , neutrophils from patients with ERA significantly enhanced the release of IL-40 following NETosis induction (p&lt;0.05) or after exposure to pro-inflammatory cytokines such as IL-1β, IL-8 (p&lt;0.05), TNF (p&lt;0.01) or to LPS (p&lt;0.05). Lastly, recombinant IL-40 induced the secretion of IL-1β (p&lt;0.05) and TNF (p&lt;0.05) by ERA neutrophils. Conclusion We demonstrated for the first time that IL-40 is upregulated in ERA and decreases after three months of conventional therapy. Moreover, we showed that neutrophils are an important source of IL-40 in RA and its release is potentiated by pro-inflammatory cytokines and NETosis. Our results suggest that IL-40 may play an important role in early stages of RA. References [1]Navrátilová A, Andrés Cerezo L, Hulejová H, Bečvář V, Tomčík M, Komarc M, et al. IL-40: A New B Cell-Associated Cytokine Up-Regulated in Rheumatoid Arthritis Decreases Following the Rituximab Therapy and Correlates With Disease Activity, Autoantibodies, and NETosis. Front Immunol. 2021 Oct 21;12:745523. doi: 10.3389/fimmu.2021.745523. Acknowledgements Supported by AZV-NU21-05-00276, MHCR 023728, SVV 260 523 and BBMRI-CZ LM2018125 Disclosure of Interests None declared